Lesson 1 Incident Size-up and Personnel Safety Emergency Care and Treatment (ECAT)

Lesson 1Lesson 1

Incident Size-up Incident Size-up and Personnel and Personnel

SafetySafety

Emergency Care and Emergency Care and Treatment (ECAT)Treatment (ECAT)

Emergency Care And Treatment (ECATEmergency Care And Treatment (ECAT) in Disasters) in Disasters

22

Incident Size-up & Incident Size-up & Personnel SafetyPersonnel Safety

• Objectives

1. Describe how your local command structure and response system works and how to perform within it.

2. Recognize the potential hazards in the emergency response and what can be done to remain safe.

3. Identify danger signs that may be observed at an emergency scene.

4. Describe several actions that may be taken to prevent injuries of the responder.


33

Incident Size-up and Incident Size-up and Personnel SafetyPersonnel Safety

What hazards are evident in this scene?


44

Incident Size-up & Personnel Incident Size-up & Personnel SafetySafety



55

Incident Size-up & Personnel SafetyIncident Size-up & Personnel Safety



66

Incident Size-up & Personnel SafetyIncident Size-up & Personnel Safety



77


I. Communication: A Safety Issue

A. First Impressions

1. How the Patient Sees You 2. Appearance and Attitude


88

I. Communication: A Safety Issue (cont’d)

B. Communication Tools

C. Interview Techniques



99

II. Driving and Traffic Safety

A. Driving for Safety

1. Basic Safety Tips

2. Seat Belts

3. Lights and Sirens

4. Hearing Protection

5. Protecting the Patient



1010


II. Driving and Traffic Safety (cont’d)

B. Staying Safe in Traffic on Foot

1. Park for Maximum Safety2. Get out of the Vehicle Safely3. Wear Protective Equipment4. Channel Traffic Away from the Scene


1111


II. Driving and Traffic Safety (cont’d)

C. Protecting Those in the Patient Compartment

1. Hanging On and Bracing

2. Securing the Patient

3. Securing Equipment

4. Performing CPR in a Moving Ambulance


1212


III. Scene Safety

A. PlanB. ObserveC. React

1. Retreat

2. Radio

3. Reevaluate


1313


IV. Personal Safety

A. Protecting Yourself from Hostile People

I. The Hostile Scene

2. Protect Your Health


1414


VI. Personal Safety (cont’d)

B. Infectious Disease Precautions

1. The Process of Transmission

2. Universal Precautions

3. Infectious Diseases


1515



C. Diseases of Concern1. Hepatitis B

a. Signs and Symptoms

b. Protective Procedures


1616



2. Tuberculosis




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3. Acquired Immunodeficiency Syndrome (AIDS)




1818



D. Preventing Infection

1. CPR and Infection

2. Recommended Immunizations

3. Hand Washing Guidelines

4. General Guidelines


1919

Don’t be blinded!Don’t be blinded!

Lesson 2Lesson 2

Kinematics of TraumaKinematics of Trauma



2121

Kinematics of TraumaKinematics of Trauma • Objectives

1. Identify mechanism of injury as an important part of the assessment of a trauma patient.

2. Identify the injuries associated with common vehicular accidents.

3. Explain the types of trauma caused by falls, stabbings, bullet wounds, and blast injuries.


2222


Introduction

I. Common Mechanisms of Injury


2323

Kinematics of TraumaKinematics of Trauma I. Common Mechanisms of Injury

(cont’d.)

A. Automobile Accidents1. Head-on Impact 2. Rear Impact3. Side Impact4. Rotational Impact5. Rollover 6. Ejections/Projections7. Restraints


2424


I. Common Mechanisms of Injury (cont’d.)

B. Motorcycle Accidents

1. Head-on Impact2. Angular Impact3. Ejection4. Laying the Bike Down


2525

Kinematics of TraumaKinematics of Trauma I. Common Mechanisms of Injury (cont’d.)

C. Recreational Vehicle Accidents1. All terrain Vehicle2. Personal Water Craft

D. BoatsE. Falls

1. Feet-first impact

2. Head-first Impact3. Angular Impact


2626


I. Common Mechanisms of Injury (cont’d.)

F. Penetrating Trauma

1. Low-Velocity Injuries2. Medium and High-Velocity Injuries

G. Blast Injuries

II. Patient Assessment


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Motion and Movement !Motion and Movement !

Lesson 3Lesson 3Airway and Breathing Airway and Breathing

with with

Spinal ManagementSpinal Management



2929

Airway & Breathing with Airway & Breathing with Spinal ManagementSpinal Management

• Objectives

1. List the initial steps of opening the airway of a patient with a spinal injury.

2. Describe how to maintain spinal immobilization when maintaining and open airway of a patient with a spinal injury.

……..(more)


3030


• Objectives (cont’d)

3. Describe the signs of respiratory distress

4. Demonstrate the steps to use an oral airway and bag-valve mask.

5. Understand the need for supplemental oxygen and how to properly and safely deliver it.


3131

Airway & Breathing with Spinal Airway & Breathing with Spinal ManagementManagement

I. Spinal Management

A. Manual immobilization

B. Cervical Collar

C. Other ways to immobilize the C-spine

D. Use of a backboard (covered in lesson 5)


3232


II. Airway

A. Patient Assessment1. Determine Unresponsiveness

a) Adultsb) Infants and Childrenc) Head, Neck, and Spine Injuries

2. Open the Airway


3333


III. Breathing

A. Assessment

1. Signs of effective breathing

2. Signs of ineffective breathing


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IV. Assisting Breathing of the Patient

A. Oral AirwayB. Bag-Valve-Mask (BVM)C. Oxygen Delivery Equipment

1. Safety precautions2. Oxygen Administration Equipment

a) Nasal Canula

b) Plastic Face Masksc) Non re-breathing Masksd) Venturi Masks

Airway and Breathing with Airway and Breathing with Spinal ManagementSpinal Management


3535

CPR ReviewCPR Review

I. Basic Life Support: Cardiopulmonary Resuscitation (CPR)

A. How the Heart Works

B. When the Heart Stops

1. Performing Chest Compressions

2. One-Person CPR

a) A Second Rescuer Takes Over

3. Two-Person CPR

a) Changing Positions

b) Monitoring the Patient


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CPR ReviewCPR Review Basic Life Support: Cardiopulmonary Resuscitation (cont’d)

C. Signs of Successful CPR

D. Mistakes in Performing CPR

E. Complications Caused by CPR

F. CPR for Infants and Children

1. Establishing Unresponsiveness or Respiratory Difficulty

2. Determining Pulselessness


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Basic Life Support: Cardiopulmonary Resuscitation (cont’d)

F. CPR for Infants and Children (cont’d)

3. Performing CPR

4. Signs of Successful CPR

5. Complications of CPR in Children

G. Pre-hospital Defibrillation

1. Management of the Sudden Cardiac Death Patient



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G. Pre-hospital Defibrillation (cont’d)

2. Automated Defibrillation

a) Step 1: Anticipation and Planning While En Route to the Scene

b) Step 2: Scene Entry and Placement

c) Step 3: Check Patient and Start CPR

d) Step 4: Prepare Patient and AttachElectrodes



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2. Automated Defibrillation (cont’d)

e) Step 5: Power On and Rhythm Analysis(1) Narration(2) Getting Clear(3) Assessment(4) Charging



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f) Step 6: Defibrillation(1) Semiautomatic AED(2) Automatic AED(3) Outcomes of Use of AEDS

g) Step 7: Patient Stabilization and Maintenance



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h) Step 8: Family Notification andSpectators

i) Step 9: Transport

j) Step 10: Transfer of Care to Hospital



4242


H. Maintenance Checklist

I. When to Terminate or Withhold CPR



4343

CPR ReviewCPR ReviewII. Obstructed Airway Emergencies

A. Types of Airway Obstruction

1. Partial Obstruction

2. Complete Obstruction

B. Emergency Care for Airway Obstruction

1. The Heimlich Maneuver

a) The Patient is Standing or Sitting

b) The Patient is Lying Down


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III. Obstructed Airway Emergencies (cont’d)

B. Emergency Care for Airway Obstruction (cont’d)

1. The Heimlich Maneuver (cont’d)

c) The Patient is Obese or Pregnant

d) You are Alone and Choking

e) The Patient is Found Unconscious


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II. Obstructed Airway Emergencies (cont’d)

B. Emergency Care for Airway Obstruction (cont’d)

2. Obstructed Airway in the Infant or Child

a) Signs and Symptoms

b) The Choking Infant

c) The Choking Infant: Unconscious

d) The Child Over the Age of One Year



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CPR ReviewCPR ReviewBasic Life Support: Artificial Ventilation (cont’d)

B. Rescue Breathing (cont’d)

3. Mouth-to-Stoma Ventilation

4. Mouth-to-Barrier Device Ventilation

a) Pocket Masks

b) Face Shields

5. Ventilating Infants and Children

C. Gastric Distention


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III. Optional Aids to Resuscitation

The Use of Airway Adjuncts


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Overcoming Obstacles!Overcoming Obstacles!

Lesson 4Lesson 4

Patient Head-to-Toe ExamPatient Head-to-Toe Exam

and What Vital Signs and What Vital Signs MeanMean



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Objectives

1. Understand the organization of proper patient assessment.

2. Describe the steps of the initial assessment.

3. Understand normal and recognize abnormal vital signs.

…..(more)


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Objectives (cont’d)

4. Understand the sequence and application of the Physical Examination.

5. Describe how to conduct a head-to-toe examination


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I. Personal and Scene Safe

A. Arrive at the Scene

1. What is the current situation?2. Where is it going?3. How do you control it?


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I. Personal and Scene Safety (cont’d)

B. Control the Scene1) Establish Authority

2) Gather Information at the Scene

3) Build Rapport with the Patient



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Patient Head-to-Toe ExamPatient Head-to-Toe ExamII. The Initial Assessment

A. Check Life-Threatening Conditions

1) Responsiveness (AVPU)

2) Airway and Cervical Spine

3) Breathing


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II. The Initial Assessment (cont’d)

A. Check Life-Threatening Conditions (cont’d)

4) Circulation and Bleeding

5) Disability

6) Expose and Examine


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III. The Physical Examination

Look for D.O.T.S.

DeformityOpen WoundsTendernessSwelling



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Patient Head-to-Toe ExamPatient Head-to-Toe ExamA. The Primary Trauma Survey

Conduct a Head-to-Toe Examination looking for D.O.T.S.

1) Head and Neck

2) Face

3) Shoulders and Clavicles

4) Chest


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Patient Head-to-Toe ExamPatient Head-to-Toe ExamA. The Primary Trauma Survey (cont’d)

Conduct a Head-to-Toe Examination (cont’d)

5) Abdomen

6) Pelvis and Lower Back

7) Lower Limbs and Feet

8) Arms, Wrists, and Hands

9) Back


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B. The Secondary Survey (cont’d)

Check Vital Signs

1) Respiration

2) Pulse

3) Skin

4) Blood Pressure

C. Check for Medical Information Devices



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D. Gather Patient History

“S.A.M.P.L.E”a) Signs and Symptoms

b) Allergies

c) Medications

d) Past Medical History

e) Last meal

f) Events leading to illness


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Patient Head-to-Toe examPatient Head-to-Toe exam

E. Ongoing Assessment

F. Patient Hand-off Report


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Gotta get him to examine him!Gotta get him to examine him!

Lesson 5Lesson 5

Lifting and Lifting and

Moving PatientsMoving Patients



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Lifting and Moving PatientsLifting and Moving Patients

Objectives

1. Understand the general guidelines of lifting and moving patients.

2. Describe and demonstrate how to use the various lifts, carries and equipment when moving patients.


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Introduction

I. General Guidelines for Moving Patients

A. When to make an Emergency Move

B. When to Make Emergency Moves

C. Lifting Techniques


6666

II. Basic Patient Moves

A. One-Rescuer Techniques

1. The Blanket Drag 2. The Shirt Drag3. The Sheet Drag4. The Firefighter’s Carry5. Other Emergency Moves

Lifting and Moving Lifting and Moving

PatientsPatients


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Lifting and Moving Lifting and Moving

PatientsPatients

II. Basic Techniques (cont’d)

B. Two- and Three-Rescuer Techniques

1. Seat Carries (Two Rescuers) 2. Extremity Lift (Two Rescuers)3. Chair Litter Carry (Two Rescuers)4. Flat Lift (Two Rescuers)5. Flat Lift and Carry (Three Rescuers)


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II. Basic Techniques (cont’d)

C. Stretchers and Backboards

1. The Canvas Litter/Pole Stretcher 2. Backboards3. Blanket Stretcher4. Improvised Stretcher5. Stretcher Transportation


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D. Putting a Patient on a backboard

1. From the Side

2. In Line


7070

Practice makes perfect!Practice makes perfect!

Lesson 6Lesson 6

Basic Injuries and Basic Injuries and TreatmentTreatment



7272

Basic Injuries and TreatmentBasic Injuries and Treatment • Objectives

Upon completion of this lesson, the participants shall be able to:

• 1 Describe the various types of open wounds and the treatment for them.

• 2 Describe the various types of closed wounds and the treatment for them.

• 3 Describe how to care for amputated parts.


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Basic Injuries and Basic Injuries and

TreatmentTreatment

I. Soft-Tissue Injuries: Closed Wounds

A. Contusions

B. Blunt Trauma


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TreatmentTreatment

II. Soft-Tissue Injuries: Open Wounds

A. Abrasions1. Emergency Care

B. Incisions1. Emergency Care


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Basic Injuries and TreatmentBasic Injuries and Treatment

II. Soft-Tissue Injuries: Open Wounds (cont’d)

C. Lacerations1. Emergency Care

D. Punctures1. Emergency Care

E. Avulsions 1. Emergency Care


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II. Soft-Tissue Injuries: Open Wounds (cont’d)

F. Bites1. Emergency Care

III. Traumatic Amputations

1. Emergency Care for the Wound

2. Emergency Care for the Amputated Part


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TreatmentTreatment

IV. Crushing, Clamping & Penetrating Injuries

A. Crushing Injuries1. Emergency Care

B. Penetrating Trauma: Stab Wounds 1. Emergency Care


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IV. Crushing, Clamping, and Penetrating Injuries (cont’d)

D. Penetrating Trauma: Gunshot Wounds1. Emergency Care

E. Impaled Objects1. General Emergency Care2. Emergency Care for the Cheek


TreatmentTreatment


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V. Burns

1. Type of burnsa) Thermalb) Chemicalc) Electricityd) Lighte) Lightningf) Radiation

2. Degree of Burnsa) First degreeb) Second degreec) Third degree

3. Emergency Care


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Taking the Checkered Flag?Taking the Checkered Flag?

Lesson 7Lesson 7

Injuries to the Head, Injuries to the Head, Face and NeckFace and Neck



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Injuries to the Head, Face & NeckInjuries to the Head, Face & Neck

• ObjectivesUpon completion of this lesson, the participants shall be able to:

• 1. Recognize the signs and symptoms of head injuries.

• 2. Describe and demonstrate the proper emergency care for head, neck and face injuries.


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I. Injuries to the Head

A. Neurological Examination

Alert?Verbal response?Pain response?Unconscious?


8484


I. Injuries to the Head (cont’d)

B. Specific Types of Head Injury

1. General Signs and Symptoms

2. Skull Fracture


8585

Injuries to the Head, Face & Injuries to the Head, Face &

NeckNeck

I. Injuries to the Head (cont’d)

3. Injuries to the Braina) General Signs and Symptomsb) Concussionc) Cerebral Contusiond) Subdural Hematomae) Epidural Hemaomaf) Penetrating Woundg) Open and Closed Head Injuries


8686

II. Injuries to the Face

A. Trauma to the Mouth and Jaw

1. Signs and Symptoms

2. Emergency Care


NeckNeck


8787

Injuries to the Head, Face & Injuries to the Head, Face & NeckNeck

III. Injuries to the Face (cont’d)

B. Fractures to the Face and Lower Jaw

1. The Facea) Signs and Symptomsb) Emergency Care

2. The Lower Jawa) Signs and Symptomsb) Emergency Care


8888


NeckNeck

III. Injuries to the Face (cont’d)

C. Objects Impaled in the Cheek

D. Injuries to the Nose

E. Injuries to the Ear


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NeckNeck III. Injuries to the Face (cont’d)

F. Injuries to the Eye

1. Foreign Objects in the Eye2. Injuries to the Orbit3. Lid Injuries4. Injuries to the Globe5. Chemical burns to the Eye6. Impaled Objects in the Eye7. Eviscerated Eyeball8. Removing hard or flexible contact lenses9. Basic rules for the Emergency Eye Care


9090


NeckNeck

III. Injuries to the Neck

A. Signs and Symptoms

B. Emergency Care


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Alert?Alert?

Lesson 8Lesson 8

Injuries to the Injuries to the

Chest and BackChest and Back



9393

Injuries to the Chest & BackInjuries to the Chest & Back


• 1. Recognize the signs and symptoms of injuries to the chest and back.

• 2. Describe and demonstrate the proper emergency care for injuries to the chest and back.


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Introduction

I. General Guidelines for Patient Care

A. Anatomy of the Chest

B. Major Signs and Symptoms1. Open and Closed Injuries

C. Principles of Emergency Care

Injuries to the Chest and Back


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II. Specific Chest Injuries

A. Flail Chest1. Signs and Symptoms2. Patient Assessment3. Emergency Care



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II.Specific Chest Injuries (cont’d)

B. Severe Blunt Injuries, Compression Injuries, and Traumatic

Asphyxia


2. Emergency Care



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II. Specific Chest Injuries (cont’d)

C. Broken Ribs


2. Emergency Care


9898


D. Sucking Chest Wound


2. Emergency Care



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E. Pneumothorax & Tension Pneumothorax


2. Emergency Care



100100


F. Hemothorax


2. Emergency Care



101101


G. Subcutaneous Emphysema


2. Emergency Care



102102


H. Penetrating Injury


2. Emergency Care



103103

III. Injuries to the Spine:

Mechanisms of Spinal Injury



104104

IV. Care for Spinal Injury

A. Patient Assessment

B. Signs and Symptoms

C. Emergency Care

D. Helmet Removal



105105

Keep hacking….. you’d get it!Keep hacking….. you’d get it!

Lesson 9Lesson 9

Injuries to the Injuries to the Abdomen and PelvisAbdomen and Pelvis



107107

Injuries to the Abdomen & Injuries to the Abdomen &

pelvispelvis


• 1. Recognize the signs and symptoms of injuries to the abdomen and pelvis.

• 2. Describe and demonstrate the proper emergency care for injuries to the abdomen and pelvis.


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PelvisPelvis

I. Abdominal Injuries

A. The Abdominal Cavity


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PelvisPelvis

I. Abdominal Injuries (cont’d.)

B. General Guidelines for Patient Care

1. Patient Assessment a) Open Woundsb) Closed Wounds


110110


PelvisPelvis


2. General Signs and Symptoms

a) Open Woundsb) Closed Wounds

3. General Emergency Care


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Injuries to the Abdomen & PelvisInjuries to the Abdomen & Pelvis


C. Specific Abdominal Injuries

1. Abdominal Evisceration

2. Hernia

3. Impaled Objects in the Abdomen


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PelvisPelvis

II. Pelvic Injuries

1. Fractures

2. Impaled Objects in the Pelvis


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Got the Guts?Got the Guts?

Lesson 10Lesson 10

Injuries to the Injuries to the ExtremitiesExtremities



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Injuries to the Extremities


• 1. Recognize the signs and symptoms of injuries to the extremities.

• 2. Describe and demonstrate the proper emergency care for injuries to the extremities.


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Introduction

I. Anatomy of the MusculoskeletalSystem



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II. Causes and Types of Musculoskeletal Injuries

A. Forces that Cause Injury



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II. Causes and Types of Musculoskeletal Injuries (cont’d)

B. Sprains and Strains

1. Signs and Symptoms2. Emergency Care


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C. Fractures

1. Types of FracturesOpenClosed

2. Signs and Symptoms of Fractures

3. Emergency Care


120120



D. Dislocations


2. Emergency Care


121121


III. General Principles of Care

A. Types of Splints

1. Improvised Splint and Sling2. Self-Splint3. Sling and Swathe

4. Pillow Splint5. Fixation Splint6. Air Splint


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III. General Principles of Care (cont’d)

B. Splinting of Fractured or DislocatedLimbs



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III. General Principles of Care (cont’d)

C. Control of Bleeding

1. Dress open wounds

2. Check: distal pulsessensationand function

before and after bandaging and splinting



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IV. Emergency Care for Specific Injuries of the Upper Extremities

1. Dislocation of the Shoulder

2. Fractures of the Clavicle

3. Fractures of the Scapula

4. Fractures of the Humerus



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IV. Emergency Care for Specific Injuries of the Upper Extremities (cont’d)

5. Dislocation of the Elbow

6. Fractures of the Forearm and Wrist

7. Fractures of the Fingers and Hand



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V. Emergency Care for Specific Injuries to the Lower Extremities

1. Fractures of the Pelvis

2. Fractures of the Hip

3. Fractures of the Femur



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V. Emergency Care for Specific Injuries to the Lower Extremities (cont’d)

4. Dislocation of the Knee

5. Fractures of the Tibia and Fibula

6. Fractures of the Ankle and Foot



128128

Keep ‘em moving!Keep ‘em moving!

Lesson 11Lesson 11Medical Concerns in Medical Concerns in

the Fieldthe Field

Emergency Care and Emergency Care and Treatment (ECATTreatment (ECAT))


130130

Medical Concerns in the FieldMedical Concerns in the Field


• 1. Recognize the signs and symptoms of medical problems in the field.

• 2. Describe and demonstrate the proper emergency care for medical problems in the field.


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I. The Scene

A. Arrive at the scene - safetyB. Control the scene

1. Establish authority – command structure2. Gather information3. Build rapport with patient


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II. Scene Safety

A. Removal of medical patient from hazardous environment

B. Triage area

Medical Concerns in the Medical Concerns in the FieldField


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III.Recognizing Medical Conditions in the Field

A. Types of medical conditions you may encounter 1. Heart attack2. Stroke3. Heat stroke – exhaustion4. Diabetic Emergencies5. Shock6. Seizure



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III. Recognizing Medical Conditions in the Field (cont’d)

B. Treatment of medical problems

1. Priority

2. Ambulatory

3. Not treatable



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IV. Primary Survey

A. Check for life-threatening conditions

1. Airway at C-spine2. Breathing3. Circulation and bleeding4. Disability5. Expose and examine


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V. The Secondary Survey

A. Medical Survey

1. Appearance

2. Level of consciousness

3. Chief complaint



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V. The Secondary Survey (cont’d)

B. History of Present Illness

1. Pain

2. Quality

3. Radiation

4. Severity



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C. Field Check of Vital Signs

1. Respirations

2. Pulse

3. Skin Quality

4. Blood pressure


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D. Conduct head-to-toe examinations

1. Medical information devices



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No problem, mon!No problem, mon!

Lesson 12Lesson 12Problem-solving in Problem-solving in

the Fieldthe Field



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Problem-solving in the FieldProblem-solving in the Field

• ObjectiveUpon completion of this lesson, the participants shall be able to:

1. Learn how to use what is at hand to provide proper care for the patient in a disaster situation.


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I. The Scene

A. Arrive at the scene - safetyB. Size upC. Situational awarenessD. Gaining access to the sceneE. Stabilizing the environment1. Stabilizing cars, boats and heavy

equipment2. Stabilizing buildings


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II. Patient Treatment

A. Recognizing and locating medical suppliesB. Recognizing and locating splinting

materialC. Short distance transfers of patients1. Patient carriesD. Stretchers in the field1. Finding material2. Building a stretcher



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III. Patient Care

A. Organizing the moving of the patient

1. Use of bystanders, etc.

2. Vehicles such as boats for transportation


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III. Patient Care (cont’d)

B. Moving patient to safe area

C. Basic water rescue

1. Safety of rescuer2. Removal of patient from the water


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THE ENDTHE END

Lesson 1 Incident Size-up and Personnel Safety Emergency Care and Treatment (ECAT)

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Transcript of Lesson 1 Incident Size-up and Personnel Safety Emergency Care and Treatment (ECAT)